Individual provider Active NPI

Dawn Marie Cohen, LCSW

  • Clinical Social Worker
  • Clermont, FL
National Provider Identifier
1740439785
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14687 Issued in FL
Practice address
205 Hatteras Ave
Clermont, FL 34711-6502
Phone
(352) 348-8858
NPI assigned
Sep 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X SW14687 FL Primary

Addresses

Primary practice location

205 Hatteras Ave
Clermont, FL 34711-6502

Mailing address

4300 S Highway 27 Ste 205C
Clermont, FL 34711-8067
Phone (352) 348-8858

Other practice location 1

1009 Maitland Center Commons Blvd
#212
Maitland, FL 32751-7270
Phone (407) 636-3532

Other identifiers 1

IdentifierTypeStateIssuer
021780300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200108001562 FL Practitioner - Clinical Social Worker 8325473937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shining Light CounselingGroup PAC ID 2163855651, 2 clinicians

Practice addresses (Care Compare)

15930 US Hwy 441
Suite D
Eustis, FL 32726-6552
Phone (352) 978-6687

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14687FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Shining Light Counseling Clinical CurrentSince Oct 15, 2019 Accepting new patients

Locations

365 Citrus Tower Blvd
Ste 108
Clermont, FL 34711
Phone (352) 978-6687

15930 US Highway 441
Ste D
Eustis, FL 32726
Phone (352) 978-6687

4400 N Highway 19A
Ste 5
Mount Dora, FL 32757
Phone (352) 315-7800

820 S Duncan Dr
Tavares, FL 32778
Phone (352) 357-1955

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1740439785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 S HIGHWAY 27 STE 205C",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118067",
            "telephone_number": "352-348-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 HATTERAS AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116502",
            "telephone_number": "352-348-8858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1009 Maitland Center Commons Blvd",
            "address_2": "#212",
            "address_purpose": "LOCATION",
            "city": "Maitland",
            "state": "FL",
            "postal_code": "327517270",
            "country_code": "US",
            "telephone_number": "407-636-3532",
            "fax_number": "321-256-5292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021780300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.